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ID PMID Title PublicationDate abstract
26443076 Rational Design of Benzylidenehydrazinyl-Substituted Thiazole Derivatives as Potent Inhibi 2015 Oct 7 Human dihydroorotate dehydrogenase (hDHODH) is an attractive therapeutic target for the treatment of rheumatoid arthritis, transplant rejection and other autoimmune diseases. Based on the X-ray structure of hDHODH in complex with lead compound 7, a series of benzylidenehydrazinyl-substituted thiazole derivatives as potent inhibitors of hDHODH were designed and synthesized, of which 19 and 30 were the most potent with IC50 values in the double-digit nanomolar range. Moreover, compound 19 displayed significant anti-arthritic effects and favorable pharmacokinetic profiles in vivo. Further X-ray structure and SAR analyses revealed that the potencies of the designed inhibitors were partly attributable to additional water-mediated hydrogen bond networks formed by an unexpected buried water between hDHODH and the 2-(2-methylenehydrazinyl)thiazole scaffold. This work not only elucidates promising scaffolds targeting hDHODH for the treatment of rheumatoid arthritis, but also demonstrates that the water-mediated hydrogen bond interaction is an important factor in molecular design and optimization.
26110105 Reactive oxygen species induce Cox-2 expression via TAK1 activation in synovial fibroblast 2015 Oxidative stress within the arthritis joint has been indicated to be involved in generating mediators for tissue degeneration and inflammation. COX-2 is a mediator in inflammatory action, pain and some catabolic reactions in inflamed tissues. Here, we demonstrated a direct relationship between oxidative stress and Cox-2 expression in the bovine synovial fibroblasts. Furthermore, we elucidated a novel mechanism, in which oxidative stress induced phosphorylation of MAPKs and NF-κB through TAK1 activation and resulted in increased Cox-2 and prostaglandin E2 expression. Finally, we demonstrated that ROS-induced Cox-2 expression was inhibited by supplementation of an antioxidant such as N-acetyl cysteamine and hyaluronic acid in vitro and in vivo. From these results, we conclude that oxidative stress is an important factor for generation of Cox-2 in synovial fibroblasts and thus its neutralization may be an effective strategy in palliative therapy for chronic joint diseases.
25459981 Diagnostic accuracy of self-reported arthritis in the general adult population is acceptab 2015 Apr OBJECTIVE: To summarize the diagnostic accuracy of self-reported osteoarthritis (OA), rheumatoid arthritis (RA), and arthritis (i.e., unspecified) in the general adult population. STUDY DESIGN AND SETTING: A systematic literature search identified studies reporting diagnostic data on self-reported diagnosis of OA, RA, or arthritis in adults in population-based or primary care samples. Index tests included any form of participant-reported presence of the condition. Reference tests included rheumatologist, physician, or health professional examination; medical record review; physician interview; laboratory tests; or radiography. Relevant articles were scored using the QUADAS tool. Diagnostic values were summarized using pooled estimates for sensitivity and specificity. RESULTS: The search strategy identified 16 articles: 11 for OA, 5 for RA, and 4 for arthritis. Four of 16 articles scored high on quality. The pooled sensitivity and specificity were 0.75 [95% confidence interval (CI): 0.56, 0.88] and 0.89 (95% CI: 0.77, 0.95) for OA, 0.88 (95% CI: 0.59, 0.97) and 0.93 (95% CI: 0.66, 0.99) for RA, and 0.71 (95% CI: 0.59, 0.80) and 0.79 (95% CI: 0.65, 0.89) for arthritis. There were not enough studies to conduct meta-analyses for joint-specific OA. CONCLUSION: The accuracy of self-reported OA and RA is acceptable for large-scale studies in which rheumatologist examination is not feasible. More high-quality studies are required to confirm the accuracy of self-reported arthritis and joint-specific OA.
25596157 MicroRNA-124 inhibits the progression of adjuvant-induced arthritis in rats. 2016 Mar OBJECTIVE: MicroRNAs (miRNAs) are small endogenous, non-coding RNAs that act as post-transcriptional regulators. We analysed the in vivo effect of miRNA-124 (miR-124, the rat analogue of human miR-124a) on adjuvant-induced arthritis (AIA) in rats. METHODS: AIA was induced in Lewis rats by injecting incomplete Freund's adjuvant with heat-killed Mycobacterium tuberculosis. Precursor (pre)-miR-124 was injected into the right hind ankle on day 9. Morphological changes in the ankle joint were assessed by micro-CT and histopathology. Cytokine expression was examined by western blotting and real-time RT-PCR. The effect of miR-124 on predicted target messenger RNAs (mRNAs) was examined by luciferase reporter assays. The effect of pre-miR-124 or pre-miR-124a on the differentiation of human osteoclasts was examined by tartrate-resistant acid phosphatase staining. RESULTS: We found that miR-124 suppressed AIA in rats, as demonstrated by decreased synoviocyte proliferation, leucocyte infiltration and cartilage or bone destruction. Osteoclast counts and expression level of receptor activator of the nuclear factor κB ligand (RANKL), integrin β1 (ITGB1) and nuclear factor of activated T cells cytoplasmic 1 (NFATc1) were reduced in AIA rats treated with pre-miR-124. Luciferase analysis showed that miR-124 directly targeted the 3'UTR of the rat NFATc1, ITGB1, specificity protein 1 and CCAAT/enhancer-binding protein α mRNAs. Pre-miR-124 also suppressed NFATc1 expression in RAW264.7 cells. Both miR-124 and miR-124a directly targeted the 3'-UTR of human NFATc1 mRNA, and both pre-miR-124 and pre-miR-124a suppressed the differentiation of human osteoclasts. CONCLUSIONS: We found that miR-124 ameliorated AIA by suppressing critical prerequisites for arthritis development, such as RANKL and NFATc1. Thus, miR-124a is a candidate for therapeutic use for human rheumatoid arthritis.
26146010 Green tea extract improves the oxidative state of the liver and brain in rats with adjuvan 2015 Aug The purpose of the study was to evaluate the possible effects of the administration of a green tea extract on the oxidative state of the liver and brain of adjuvant-induced arthritic rats, a model for human rheumatoid arthritis. Daily doses of 250 mg kg(-1) (59.8 mg catechins per kg) for 23 days were administered. This treatment produced significant diminutions in protein and lipid damage in liver, brain and plasma. It also diminished the tissue ROS contents and increased the antioxidant capacity of the plasma. The antioxidant defenses, which are diminished by arthritis, were improved by the green tea treatment, as revealed by the restoration of the GSH and protein thiol levels and by the strong tendency for normalizing the activities of the antioxidant enzymes. The activity of glucose 6-phosphate dehydrogenase, which is increased by arthritis in the liver, was also almost normalized by the treatment. In conclusion, it can be said that green tea consumption is possibly beneficial for the liver and brain of patients suffering from rheumatoid arthritis because it attenuates the pronounced oxidative stress that accompanies the disease and, thus, diminishes the injury to lipids and proteins in both liver and brain. There are also indications that, in the liver, the green tea can contribute to normalize the metabolic functions that are substantially modified by arthritis. For example, the green tea normalized the activity of glucose 6-phosphate dehydrogenase, a key enzyme of an important metabolic route (pentose monophosphate pathway). It is expected that the green tea treatment is equally able to normalize the activity of other enzymes (e.g., glucokinase and glucose 6-phosphatase), a hypothesis to be tested by future work.
25665892 Dietary extra-virgin olive oil prevents inflammatory response and cartilage matrix degrada 2016 Feb PURPOSE: Current experimental studies support a beneficial role of extra-virgin olive oil (EVOO) in several inflammatory diseases. The present study was designed to evaluate the effects of dietary EVOO on type II collagen-induced arthritis (CIA) in mice. METHODS: DBA-1/J mice were randomized in four experimental groups (10 or 15 animals per group): (1) Sham sunflower diet (SO-Sham), (2) CIA sunflower diet (SO-CIA), (3) Sham EVOO diet (EVOO-Sham) and (4) CIA EVOO diet (EVOO-CIA) group. After 6 weeks, arthritis was induced by type II collagen. Mice were sacrified 42 days after first immunization. In addition to macroscopic and histological analyses, serum levels of cartilage olimeric matrix protein (COMP), metalloproteinase-3 (MMP-3) and pro-inflammatory cytokines levels were evaluated by ELISA. The expressions of heme oxygenase-1 (HO-1), nuclear factor E2-related factor 2 (Nrf2), mitogen-activated protein kinases (MAPKs), Janus kinase-signal transducer and activator of transcription (JAK/STAT) and nuclear transcription factor-kappa B (NF-κB) pathways were studied by western blotting. RESULTS: EVOO diet significantly reduced joint edema and cartilage destruction, preventing the arthritis development. Dietary EVOO significantly decreased serum COMP and MMP-3 levels, as well as, the pro-inflammatory cytokines levels (TNF-α, IL-1β and IL-17). Moreover, the activation of JAK/STAT, MAPKs and NF-κB pathways was drastically ameliorated. According to Nrf2 and HO-1, the protein expressions were up-regulated in those mice fed with EVOO. CONCLUSION: These results support the interest of EVOO as a beneficial functional food to prevent the development of the rheumatoid arthritis (RA).
27099470 Cost-effectiveness of routine measuring of serum drug concentrations and anti-drug antibod 2016 Monitoring of anti-drug antibodies (ADAbs) or serum concentrations of biologicals in treatment of rheumatoid arthritis could provide an explanation for a loss of efficacy and help in the choice of subsequent medication. Current clinical practices do not generally include such monitoring of tumor necrosis factor (TNF)-α blockers on a routine basis. The main aims of this study were to estimate the probabilities of optimal and nonoptimal treatment decisions if infliximab or adalimumab drug trough level (DL) and ADAbs are tested or not in rheumatoid arthritis, and to model cost-effectiveness of performing such monitoring on a routine basis. Data on DLs and ADAbs concentrations were obtained in Finland from clinically requested monitoring analyses of 486 and 1,137 samples from patients on adalimumab and infliximab, respectively. DL was within the target range in 42% of samples from adalimumab- and 50.4% of infliximab-treated patients. ADAbs were detected in approximately 20% and 13.5% of samples from adalimumab- and infliximab-treated patients, respectively. ADAbs were found in 52.3% and 41.3% of those with low adalimumab or infliximab DLs, respectively. The monitoring data were incorporated into probabilities for making the optimal treatment decision. Economic impact of clinical decision-making was modeled in a short-term (3-6 months) scenario with 100 hypothetical patients. In the model, the combined measurement of DLs and ADAbs was cost-saving compared to the nontesting scenario when the monitoring results affected the treatment decision in at least 2-5 of 100 patients, a proportion which is easily exceeded in real-life clinical practice. This study indicates that routine monitoring of drug level and ADAbs is cost-beneficial in clinical practice, thereby improving the decision-making process in using TNF-α blockers.
29052497 Meloxicam-loaded Phospholipid/solutol® HS15 Based Mixed Nanomicelles: Preparation, Charac 2016 BACKGROUND: Rheumatoid arthritis (RA) is a debilitating disease which results in joint destruction, mainly due to chronic inflammation and oxidative stress. Meloxicam (MLX) is a preferential cyclooxygenase-2 (COX-2) inhibitor with potential free radical scavenging activity. Mixed nanomicelles (NMs) of MLX can augment its antioxidant effects. OBJECTIVE: The present study aims to prepare, characterize, and evaluate the in vitro antioxidant effects of MLX-loaded mixed nanomicelles (MLXNMs). METHOD: Conventional thin-film hydration method was employed to fabricate MLX-NMs. The formulations were characterized for particle size, zeta potential, entrapment efficiency (EE), and drug loading (DL). Additionally, the optimized formulation was characterized for small-angle neutron scattering (SANS), in vitro drug release, and morphology. MLX encapsulation in NMs was confirmed by Fourier Transform Infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), 1H nuclear magnetic resonance (NMR), and X-ray diffraction (XRD), studies. The cell uptake of sulforhodamine B (SRB)- labeled NMs was studied in RAW 264.7 cells. The in vitro antioxidant activity of optimized MLX-NMs was studied by different antioxidant assays. RESULTS: The optimized MLX-NMs exhibited average size and zeta potential of 88 ± 42 nm and -47.4 ± 16.2 mV, respectively. The EE and DL of MLX were 94.13 ± 1.01 % and 4.20 ± 0.05 %, respectively. Morphology studies confirmed the oblate ellipsoidal shape of MLXNMs. The in vitro release study exhibited a biphasic release pattern. MLX encapsulation into the micelle core was confirmed by FTIR, DSC, 1H NMR, and XRD studies. Additionally, SRB-labeled NMs demonstrated efficient in vitro cell uptake in RAW 264.7 cells. Furthermore, in vitro antioxidant studies exhibited superior free radical scavenging activity of MLXNMs as compared to free MLX. CONCLUSION: The NMs potentiate the in vitro antioxidant effects of MLX.
26099642 Clinical analysis of preoperative deep vein thrombosis risk factors in patients undergoing 2015 Nov OBJECTIVES: The objective of this retrospective study was to investigate the risk of deep vein thrombosis (DVT) in patients admitted to hospital for total hip arthroplasty (THA). METHODS: From September of 2003 to December of 2010, 505 patients admitted for THA were eligible for the retrospective study. The diagnosis of preoperative DVT, which was based on previous venous thromboembolism (VTE) management studies, was confirmed by Doppler ultrasonography. The prevalence of silent DVT in lower limbs in patients before THA was assessed. And the risk factors for preoperative DVT were investigated the correlation of DVT in the patient's background and medical history. RESULTS: Preoperative DVT was diagnosed in 62 of 505 (12.3%) patients overall. Significantly elevated risks of DVT were found in patients with increased age, a history of major surgery, revision THA, rheumatoid arthritis (RA), and a history of cancer treatment. Multiple linear regression analysis showed that increased age, RA, and history of major surgery were the independent risk factors for preoperative DVT in this study. CONCLUSIONS: A high prevalence (12.3%) of preoperative DVT was found in patients admitted to hospital for THA. Patients with increased age, RA, and a history of major surgery may be at an increased risk of preoperative DVT. The present results suggest that instrumental screening should be encouraged, at least in subgroups at higher risk of preoperative DVT.
26640499 Shikonin Inhibits Inflammatory Response in Rheumatoid Arthritis Synovial Fibroblasts via l 2015 Background. Shikonin is a major chemical component of zicao that possesses anti-inflammatory properties and the ability to mediate cellular and humoral immunity, especially in rheumatoid arthritis (RA). We investigated the impact of shikonin on inflammatory response in RA synovial fibroblasts using the CAIA model. Methods. Severe polyarticular arthritis was induced in Balb/c female mice. Expressions of lncRNA-NR024118, SOCS3, proinflammatory cytokines, and MMPs were evaluated using RT-RCR. Histone acetylation and SOCS3 protein expression were assessed by ChIP assay and western blot, respectively. Results. Mice treated with shikonin showed an abrogation of soft tissue and bone lesions. Shikonin remarkably enhanced the expression of NR024118 and SOCS3 and suppressed the secretion and expression of IL-6, IL-8, and MMPs. Proliferation of cultured RA synovial fibroblasts in the presence of IL-1β was also significantly inhibited by shikonin. Moreover, shikonin dose-dependently increased acetylation of histone H3 at the promoter of NR024118. Finally, NR024118 overexpression and interference significantly changed SOCS3 expression and NR024118 interference could reverse regulation of shikonin on SOCS3, proinflammatory cytokines, and MMPs expression level in MH7A cells. Conclusion. Our results reveal that, in the CAIA mouse model of RA, shikonin has disease modifying activity that is attributable to the inhibition of inflammatory response via lncRNA-NR024118.
27890168 Incidence and Prevention of Herpes Zoster Reactivation in Patients with Autoimmune Disease 2017 Feb Herpes zoster is the reactivation of latent varicella zoster virus usually occurring decades after initial exposure, and manifesting as a painful vesicular rash occurring along one or more dermatomes. Zoster incidence increases with age as cell mediated immunity against latent virus wanes. Epidemiological evidence suggests that individuals with underlying rheumatic diseases are at increased risk for zoster. It remains unclear whether this is due to immunosuppressive medications or from immune dysregulation of the underlying disease. A vaccine against zoster is available for individuals 50 years and older. Theoretical risks remain about using this live-attenuated virus vaccine in immunosuppressed individuals.
30375574 Relationship Between Leptin and Neopterin Levels and Disease Activation Parameters in Pati 2016 Dec OBJECTIVES: This study aims to determine serum leptin and neopterin levels in patients with rheumatoid arthritis (RA) and investigate the relationship between clinical and laboratory parameters of disease activity and radiographic progression. PATIENTS AND METHODS: The study included 33 RA patients (9 males, 24 females; mean age 52.5±12.3 years; range 29 to 75 years) and age- and sex-matched 24 healthy controls (11 males, 13 females, mean age 42.5±14.8; range 18 to 75). RA patients were divided into three groups based on Disease Activity Scores in 28 joints (DAS28) as low disease activity, moderate disease activity, and high disease activity groups. Of the patients, 13 (39.4%) had low disease activity (DAS28=2.6-3.2), 12 (36.4%) had moderate disease activity (DAS28=3.2-5.1), and eight (24.2%) had high disease activity (DAS28≥5.1). RESULTS: Mean serum leptin and neopterin levels in the RA group were 23.98±18.88 ng/mL and 1.88±1.84 nmol/L, respectively. Mean serum leptin and neopterin levels in the control group were 19.40±13:42 ng/mL and 1.13±0.55 nmol/L, respectively. There was no statistically significant difference in the levels of serum leptin (p=0.674) and neopterin (p=0.078) between RA patients and control group. Serum leptin (p=0.574) and neopterin (p=0.921) levels in RA patients and control group showed no correlation with body mass index levels. Besides, there was no correlation between age and plasma leptin and neopterin levels and rheumatoid factor positivity, anti-cyclic citrullinated peptide antibodies, disease duration, erythrocyte sedimentation rate, and C-reactive protein levels in RA group. In RA patients, there was no correlation between serum leptin and neopterin levels and clinical and laboratory parameters indicating the disease activity. In RA patients, there was also no correlation between radiographic joint damage and serum leptin and neopterin levels. A positive correlation was shown in RA patients between disease duration and modified Larsen score (p=0.01). CONCLUSION: In our study, no correlation was detected between serum leptin and neopterin levels and disease activity parameters in RA patients. Therefore, leptin and neopterin levels may not be considered as beneficial inflammation parameters to be used in the diagnosis of RA and disease activation tracking.
25982478 A novel splice variant of human L-selectin encodes a soluble molecule that is elevated in 2015 Jul 10 L-selectin, a type I membrane protein, is a leukocyte adhesion molecule that mediates both lymphocyte homing to peripheral lymph nodes and leukocyte accumulation at sites of inflammation. L-selectin is rapidly shed from the cell surface after cellular activation, and the ectodomain thus released is thought to account for high levels of soluble L-selectin in serum. In this study, we report the identification of a novel, naturally occurring isoform of the human L-selectin gene. Sequence analysis revealed that this isoform is generated by an alternative splicing event: the 7th exon of the human L-selectin gene, which encodes the region containing the transmembrane domain, is excluded, predicting a soluble protein product. The mRNA for this splice variant was expressed in lymphoid organs, where conventional L-selectin mRNA was also expressed. Activating T cells increased the variant mRNA and its ratio to the membrane form. Soluble L-selectin translated from the variant mRNA was present in human serum, albeit at a much lower level than that arising from ectodomain shedding, and was markedly elevated in patients with various rheumatic diseases, including rheumatoid arthritis and systemic lupus erythematosus. These observations indicate that some of the soluble L-selectin present in human serum arises through alternative splicing, which may be upregulated during lymphocyte activation in patients with various clinical conditions.
25674182 Comparing Five Year Out-Come in Two Cohorts of Patients with Early Rheumatoid Arthritis - 2015 The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively. METHODS: All 2235 patients with early RA (disease duration ≤12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6. RESULTS: At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point. CONCLUSION: Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.
25534978 Autoimmune disease in the epigenetic era: how has epigenetics changed our understanding of 2015 Jan Autoimmune diseases are complex and enigmatic, and have presented particular challenges to researchers seeking to define their etiology and explain progression. Previous studies have implicated epigenetic influences in the development of autoimmunity. Epigenetics describes changes in gene expression related to environmental influences without alterations in the underlying genomic sequence, generally classified into three main groups: cytosine genomic DNA methylation, modification of various sidechain positions of histone proteins and noncoding RNAs feedback. The purpose of this article is to review the most relevant literature describing alterations of epigenetic marks in the development and progression of four common autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and Sjögren's syndrome. The contribution of DNA methylation, histone modification and noncoding RNA for each of these disorders is discussed, including examples both of candidate gene studies and larger epigenomics surveys, and in various tissue types important for the pathogenesis of each. The future of the field is speculated briefly, as is the possibility of therapeutic interventions targeting the epigenome.
28040332 Rheumatoid arthritis seems to have DMARD treatment decision influenced by fibromyalgia. 2016 Dec 18 OBJECTIVE: To compare DMARD use in patients with and without FM over time, including overtreatment and undertreatment rates in both groups. METHODS: A prospective cohort study with patients attending an RA outpatient clinic was conducted. Participants were consecutively recruited between March 2006 and June 2007 and were followed through December 2013. Data on DMARD use (prevalences, doses and escalation rates), DAS28, HAQ and radiographic progression were compared among RA patients with FM and without FM. Mistreatment clinical scenarios were allegedly identified and compared between groups. RESULTS: 256 RA patients (32 with FM) were followed for 6.2±2.0 (mean±SD) years comprising 2,986 visits. At baseline, RA duration was 11.1±7.4 years. DAS28 and HAQ were greater in RA with FM group, and were closer to RA without FM group towards the end. RA patients with FM used higher doses of tricyclic antidepressants, leflunomide and prednisone, and lower doses of methotrexate. When compared to RA patients without FM, participants with RA and FM used more often tricyclic antidepressants, leflunomide, prednisone, continuous analgesics and less often methotrexate. Groups presented similar 7-year biologic-free survival, and radiographic progression-free survival in Cox regression. RA patients with FM had greater proportions of visits in mistreatment scenarios when compared to RA patients without FM (28.4 vs. 19.8%, p<0.001). CONCLUSIONS: RA patients with FM used more leflunomide and prednisone, and RA mistreatment was more frequent in FM patients. Certainly, RA patients with FM will benefit from a personalized T2T strategy, including ultrasound (when suitable) and proper FM treatment.
27407269 Efficacy of radiation synovectomy (radiosynovectomy or radiosynoviorthesis) with yttrium-9 2016 OBJECTIVES: Hypertrophic and exudative synovitis of the knee is one of the earliest symptoms in rheumatic diseases. In the case of pharmacotherapy failure, other methods which directly remove the inflamed synovial membrane are used - synovectomies. Radiosynovectomy (RSV) is the radiopharmaceutical application of colloidal solution to joint cavities. In this study, the authors assessed the efficacy of knee radiosynovectomy with yttrium-90 (Y-90) in several groups of patients divided into certain rheumatic diseases. MATERIAL AND METHODS: The study group consisted of 70 patients aged from 29 to 65 years with hypertrophic and exudative synovitis of the knee in rheumatic diseases such as rheumatoid arthritis, osteoarthrosis and spondyloarthropathies. Radiopharmaceutical colloid of Y-90, with a radiation dose of 185-222 MBq in a volume of 2-3 ml, was administered to joint. Then the knee joint was immobilized for 72 h. During visits V1, V2, V3 and V4, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured and ultrasound of the knee was performed. Disease activity was evaluated by the WOMAC scale, HAQ and 100-mm visual analog scale (VAS). RESULTS: The most significant difference of synovial hypertrophy, before and after the procedure, was obtained in patients with rheumatoid arthritis. Variability of effusion before and after the procedure in all groups was comparable and statistically significant. The greatest improvement in variability of inflammatory parameters, before and 4 weeks after radiosynovectomy, was observed in patients with rheumatoid arthritis. CONCLUSIONS: In the therapeutic algorithm radiosynovectomy should be located between conservative treatment and operative procedures. Radiosynovectomy does not require hospitalization or prolonged rehabilitation. Radiosynoviorthesis affects the patient's general condition, which is associated with eliminating pain and restoring joint function.
27175294 When rheumatologists report that they agree with a guideline, does this mean that they pra 2016 INTRODUCTION: The European League Against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) and the treat-to-target (T2T) principles have been developed in order to improve the treatment outcome of patients with RA, and have received broad attention. It is not clear, though, whether these recommendations are indeed followed up in clinical practice. OBJECTIVE: To investigate if rheumatologists that report to agree with existing guidelines indeed follow them up in clinical practice. METHODS: The International Recommendation Implementation Study (IRIS) included 132 participating rheumatologists from 14 countries. Participating rheumatologists received a questionnaire measuring their awareness/commitment with the EULAR/T2T recommendations and followed a dedicated educational programme. Subsequently, they were asked to enrol 5-10 patients with new-onset RA in the online IRIS database and monitor disease activity and treatment for a period of 1-2 years. Four recommendations (3 from the EULAR recommendations and one from the T2T recommendations) were selected on the basis of testability, and analysed with regard to compliance by participating rheumatologists. RESULTS: In total, 72 of the 132 participating rheumatologists contributed 378 patients to the database. Of these participants, 70 (98%) agreed upfront with the recommendation that disease-modifying antirheumatic drug (DMARD) therapy should be started as soon as possible after diagnosis in every patient; 69 (96%) of the rheumatologists agreed with the recommendation that methotrexate (MTX) should be part of the first treatment strategy. When measuring the actual performance, it was found that the recommendation on early DMARD start was met in 253 (67%) of the recorded patients, and the recommendation on MTX in 225 (60%) of the recorded patients. Of the participants, 60 (83%) agreed that composite measures should be recorded regularly, but only in 134(54%) of the patients were composite scores actually recorded in ≥50% of patient visits. CONCLUSION: Reporting to be compliant with EULAR recommendations and T2T principles, even after dedicated education does not mean they actually comply with it in clinical practice.
26987702 Anti-Mitotic Spindle Apparatus Antoantibodies: Prevalence and Disease Association in Chine 2016 Sep BACKGROUND: Mitotic spindle apparatus (MSA) antibodies are rare findings with undefined clinical significance in clinical research. We aimed at investigating the prevalence and clinical significance of anti-MSA antibodies in Chinese population. METHODS: Between 2008 and 2013, a total of 180,180 patients were studied for the presence of anti-MSA antibodies. The clinical details and laboratory data of anti-MSA-positive patients were retrospectively collected and analyzed. RESULTS: Of the 180,180 patients tested, 68,640 patients presented with positive antinuclear antibodies (ANAs, 38.10%), but only 32 patients with positive anti-MSA antibodies (0.018%). Diagnoses were established in 22 of 32 patients: 16 connective tissue diseases (CTDs), mainly Sjogren syndrome (SS, 5/16), rheumatoid arthritis (RA, 4/16), and systemic lupus erythematosus (SLE, 3/16), and 6 nonautoimmune conditions. The most frequent clinical symptoms of the anti-MSA-positive patients were arthralgia and eyes and mouth drying. Additionally, 70% of anti-MSA antibodies were not associated with other ANAs, however, when associated, the most frequent ANA was anti-SSA. CONCLUSIONS: Anti-MSA antibodies have a low prevalence and female gender predominance. Anti-MSA antibodies are primarily associated with CTDs, mainly SS, RA, and SLE. The presence of anti-MSA antibodies might be the unique serological markers of the CTDs, especially when anti-SSA, SSB, and dsDNA antibodies are negative, or the level of RF is low.
26683150 Cytokine-producing B cells: a translational view on their roles in human and mouse autoimm 2016 Jan B-cell depletion therapy has beneficial effects in autoimmune diseases. This is only partly explained by an elimination of autoantibodies. How does B-cell depletion improve disease? Here, we review preclinical studies showing that B cells can propagate autoimmune disorders through cytokine production. We also highlight clinical observations indicating the relevance of these B-cell functions in human autoimmunity. Abnormalities in B-cell cytokine production have been observed in rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and systemic lupus erythematosus. In the first two diseases, B-cell depletion erases these abnormalities, and improves disease progression, suggesting a causative role for defective B-cell cytokine expression in disease pathogenesis. However, in the last two disorders, the pathogenic role of B cells and the effect of B-cell depletion on cytokine-producing B cells remain to be clarified. A better characterization of cytokine-expressing human B-cell subsets, and their modulation by B cell-targeted therapies might help understanding both the successes and failures of current B cell-targeted approaches. This may even lead to the development of novel strategies to deplete or amplify selectively pathogenic or protective subsets, respectively, which might be more effective than global depletion of the B-cell compartment.